Heavy menstrual bleeding is par for the course for some women. Their mother had it, their sisters have it, and they figure there's nothing that can be done about it. For some women, however, it may be a sign of a bigger health problem. In fact, studies that indicate heavy periods might be caused by a blood clotting disorder.
Heavy menstrual bleeding (also called menorrhagia) is a major hassle but may also cause serious health problems including anemia and complications in pregnancy. Sometimes heavy periods are treated with potentially dangerous hormones and surgery. A study published in the July 2009 journal of the American College of Obstetricians and Gynecologists (ACOG) says however, that as many as 25 percent of women with heavy menstrual bleeding may actually have an undiagnosed bleeding disorder.
The Centers for Disease Control & Prevention (CDC) say the most common bleeding disorder is called von Willebrand disease (VWD). VWD results from a deficiency or defect in the body's ability to make von Willebrand factor, a protein that helps blood clot. Although VWD occurs in men and women equally, women are more likely to notice the symptoms because of heavy or abnormal bleeding during their menstrual periods and after childbirth.
Many doctors assume bleeding is caused by a hormone imbalance or fibroids and never do simple blood tests that could rule out a clotting disorder. Some women may actually have surgery to remove their uterus (hysterectomy) and eliminate heavy bleeding when actually they could have been treated for a clotting disorder.
ACOG has made recommendations to screen women with menorrhagia for VWD. Women who should be tested include:
- Adolescents with severe heavy periods (they should be tested before hormone therapy is prescribed)
- Adult women with significant heavy periods that cannot be explained by other causes
- Women who are about to have hysterectomies for excessive menstrual bleeding
Women with any of the following factors should talk to their doctor about being screened:
- A personal history of heavy periods
- Blood disorders among family members
- Bruises when no injury has occurred
- Bleeding for more than five minutes with minor wounds
- Excessive or prolonged bleeding after a dental extraction
- Bleeding with flossing or brushing of teeth
- Surgical bleeding that is greater than expected
- Hemorrhaging that requires blood transfusions
- Postpartum hemorrhaging that occurs in the days after delivery
Tell your doctor if heavy periods run in your family. This may be an important clue that indicates a genetically inherited bleeding disorder. The CDC says that although there is no cure for these bleeding disorders, treatment is available to control symptoms once a disorder is identified.
